Government publishes first NHS league tables, naming worst-performing trusts including Queen Elizabeth Hospital King's Lynn

The UK government on Tuesday published the first public performance league tables for NHS trusts, naming the lowest-ranked hospitals, ambulance services and mental health providers and identifying where ministers say urgent intervention is required.

The new rankings score trusts across seven areas, including waiting times for operations, cancer treatment timeliness, time spent in A&E, ambulance response times and financial performance. Health Secretary Wes Streeting said the tables are intended to show "where urgent help is required" and to ensure "every patient deserves top of the table care," according to comments reported by the Daily Mail.

The analysis ranked Queen Elizabeth Hospital King's Lynn NHS Foundation Trust as the worst-performing general hospital overall, placing it 134th out of 134 trusts. The trust recorded 52.1 percent of A&E patients seen, admitted, transferred or discharged within four hours in July — well below the 95 percent standard set by NHS guidance. On cancer pathways, 53.4 percent of patients referred urgently were seen within two months, compared with an 85 percent target, and 86.9 percent of patients began treatment within 31 days of decision to treat in June, below the 96 percent target. The trust also met the suspected-cancer communication standard for 70 percent of patients, under the 75 percent goal.

The Care Quality Commission (CQC) rated the hospital "requires improvement" after an inspection last year, citing concerns in surgery, end-of-life care and outpatient services. The hospital has faced repeated building safety and maintenance problems; it remains propped with more than 1,500 supports to secure ceilings and is affected by reinforced autoclaved aerated concrete (RAAC), a lightweight material used in construction between the 1950s and 1990s that regulators and engineers have said can be prone to moisture-related weakening. The trust is one of seven prioritised for rebuilding under the national New Hospitals Programme. Interim executive managing director Chris Brown said the trust was "sorry it had fallen short" and that "immediate steps are being taken to address the issues."

The Countess of Chester NHS Trust, where serial killer nurse Lucy Letby previously worked, was placed in the penultimate position in the rankings. The table also revealed regional and urban-rural disparities: more than half of the 20 lowest-ranked general hospitals are located in the North of England, while London dominates the top half of the table.

Among medium-sized trusts, North Cumbria Integrated Care NHS Foundation Trust was ranked 130th out of 134. CQC reports cited failures to meet standards in emergency and medical care, including staffing shortages, gaps in infection control and delays in giving timely pain relief. Inspectors also found that some staff said they did not feel able to raise concerns without fear of blame, and that not all staff in maternity services had key training such as life support and safeguarding. The trust, which runs the Cumberland Infirmary in Carlisle, was reported to be in a "deteriorating" financial position and had a deficit of £34.71 million as of December 2024, a factor that contributed to its league-table position because the ratings penalise significant overspending.

University Hospitals Coventry and Warwickshire NHS Trust, ranked 132nd, was identified as the worst-performing teaching hospital in the analysis. The trust has faced legal action from more than 20 former patients who allege they were exposed to unnecessarily prolonged treatment with the cancer drug temozolomide. Lawyers investigating the cases said some patients were prescribed the drug for many years rather than the months typically appropriate, and reported a range of long-term harms including fatigue, joint pain, gastrointestinal problems and fertility impacts. The trust has said it is carrying out an internal review. Operationally, the trust recorded 60.4 percent of A&E patients seen within four hours and 64.2 percent of urgent cancer referrals seen within two months, both below national standards.

Mid and South Essex University Hospitals Foundation Trust, ranked 123rd, was named the worst large trust. It is one of ten trusts subject to a "rapid national investigation" into maternity and neonatal services announced earlier this year, after regulators identified concerns about the level of risk for women and babies. A CQC inspection published in January rated maternity services as "requires improvement" and found gaps in staffing and shortages of fetal monitoring equipment, with some equipment overdue testing. Latest NHS figures show 49.58 percent of patients referred for elective treatment were seen within the 18-week target in June 2025, well under the expected standard.

In the community trust category, Birmingham Community Healthcare NHS Foundation Trust was ranked 61st out of 61. The CQC found health visitor teams were carrying high caseloads amid low staffing and morale, and that systems and processes were not always reliable to keep people safe. Board papers in June also identified non-compliance with required digital security standards, raising the risk of a severe cyber attack; non-executive director Chichi Abraham-Igwe warned that gaps in skills, infrastructure and cyber protection were a "significant area of risk for the trust."

The new league tables apply a composite score that includes clinical performance and financial metrics. That means a trust with strong clinical outcomes can be downgraded if it is running a larger-than-expected deficit, according to the methodology accompanying the publication. NHS leaders and regulators have increasingly emphasised transparency on performance data, and the government framed the release as part of Labour's broader pledge to reform a health service it has described as "broken." Officials said that public rankings would help target support and interventions more precisely.

Health campaigners and local leaders will closely scrutinise the published data in the coming weeks as trusts respond with plans to address failings flagged by the CQC and the league tables. Some trusts named in the lowest positions are already under formal improvement programmes, face rebuilding programmes for ageing estates, or are the subject of independent investigations into clinical incidents and care pathways. The Department of Health and Social Care, NHS England and individual trusts have said they will continue work to tackle backlogs, reduce waiting times and stabilise finances, while regulators monitor progress through inspections and follow-up reports.